Ankle / Foot Pain
While extremity problems are addressed in other areas of this website, Ankle and Foot Pain problems are so common that we felt it deserved its’ own section. And while all or most of the considerations discussed in the Extremities section also apply to the Ankle and Foot we wanted to highlight a few concepts.
The Ankle and Foot are, of course, the foundation that everything else stands on and are
therefore extremely important to all the other structures of the body. So not only do we need to pay attention to pain and dysfunction in the Ankle and Foot itself, we also need to be acutely aware that problems in the Ankle and foot can cause problem and imbalances elsewhere in the body, especially in the knee, the hip and the pelvis.
The Ankle and Foot are a wonderful piece of engineering, and there are three distinct arches in the foot. Most people know about the longitudinal arch on the inside of the foot, usually simply called the “arch.” But there is also a “Metatarsal Arch” in the forefoot that sits transversely behind the toes. And there is a small “Lateral Arch” at the outside of the foot.
Problems of the Longitudinal Arch usually involve a dropping or flattening of the arch. This can cause strain on the joints of the arch, and hence, pain. But, as the arch becomes flattened, it can also cause significant stretching on the Plantar Fascial Tendon, causing the painful condition known as “Plantar Fasciitis.” Plantar Fasciitis is a painful stretching or tearing of the Plantar Fascial tendon, especially where the tendon attaches to the Calcaneus, or heel bone, up and under the back of the arch. Over time the body can react to this chronic inflammation and actually create a bone, or heel, spur there. Plantar Fasciitis can often be helped by Chiropractic Manipulative Therapy, Exercises, Stretches, Ice Therapy, Ultrasound, Low-level Laser Therapy, and Acupuncture. And in many cases ankle orthotics are utilized to help stabilize the mechanics of the foot while walking.
Metatarsal Arch problems also usually involve a dropping or flattening of the arch. This usually results in Metatarsal head pain, also known as “Metatarsalgia.” This may or may not be accompanied by a “neuroma” formation, which is a swelling of the nerve fibers between the metatarsal heads. Metatarsalgia commonly responds quite well to Chiropractic Manipulative Therapy and also the use of supportive orthotics to support the arch and help normalize foot mechanics.
The Lateral Arch is rarely involved but when it is it usually involves localized pain around the irritated joints of the arch.
In addition to these three arch problems, there are two bones in the Ankle and Foot that are commonly involved. The Talus is the bone at the top of the ankle that articulates with the two shin bones, the Tibia and Fibula. It is considered to be the “Master Bone of the Foot” and is almost always involved in any kind of foot pathology. It usually responds well to Manipulative Therapy. The other bone is the Calcaneus, or heel, bone. The Calcaneus commonly gets rotated inwardly, especially with inversion ankle sprains. It can also get jammed upwards by impact injuries. It, too, usually responds well to Manipulative Therapy.